Presentation
CONCLUSION: The present study represents the larger series of uterine carcinosarcoma studied in Portugal and reflects the clinical presentation, histopathological characteristics and stage at diagnosis and confirms the aggressiveness of this rare tumor [ncbi.nlm.nih.gov]
Whilst often presented as polar causations, in reality, the balance between the placental and maternal component is likely to vary across the spectrum of gestational age at clinical presentation. [isshp.org]
The condition appears to be present in a developing fetus, but estrogen levels during puberty are thought to trigger the symptoms. Symptoms are generally present during the reproductive years. [medicalnewstoday.com]
Establishing the source of bleeding is an essential first step when assessing women* who present with per vaginum (PV) bleeding. [bpac.org.nz]
Entire Body System
- Pain
You could be diagnosed with mild endometriosis with severe pain, or you could have advance endometriosis with no pain or you may experience a bit of pain. [sciencetimes.com]
However, other options are available: pain clinics can offer specialised pain-management support for those in chronic pain transcutaneous electrical nerve stimulator (TENS) machines, which prompt the body to produce its own pain-reducing endorphins, can [leading-medicine-guide.com]
Symptoms of Endometriosis Endometriosis Symptoms Pain, including pelvic or lower abdominal pain and pain with menses, is the most common symptom of endometriosis. Women may also have pain with intercourse. [uclahealth.org]
Common signs and symptoms of endometriosis include: Painful periods (dysmenorrhea). Pelvic pain and cramping may begin before and extend several days into a menstrual period. You may also have lower back and abdominal pain. Pain with intercourse. [mayoclinic.org]
However, when women do experience signs and symptoms of endometriosis they may include: Pelvic pain that may worsen during menstruation Painful intercourse Painful bowel movements or urination Infertility Pelvic pain during menstruation or ovulation can [medicinenet.com]
- Infertility
Infertility Hello! I am Dr. Yukti Wadhawan. I am an IVF specialist. I am the founder of Origin IVF. Aaj hum infertility ke baare mein baat karenge. Infertility means the inability to conceive after 12 months of unprotected intercourse. [lybrate.com]
Women who were infertile, had a family history of cancer, and who had never been pregnant also had higher rates of hyperplasia. [webmd.com]
A study in Italy of 30 infertile women and 36 controls (who had already given birth to at least one child) looked into whether HHV-6A might be correlated with infertility. All the women in the study had endometrial biopsies. [verywellfamily.com]
Endometriosis is more common in women who are experiencing infertility than in fertile women, but the condition does not necessarily cause infertility. Most women with endometriosis have no symptoms. [medicinenet.com]
- Inflammation
Second, the activation of complement and coagulation cascades promotes muscle contraction, chemotaxis, phagocyte recruitment, and peritoneal inflammation. Third, Ephrin A-mediated axon guidance promotes retrograde menstruation. [ncbi.nlm.nih.gov]
Sporadic inflammation of the mucous membrane lining the uterus (endometriosis), or endometriosis caused by a tuberculosis infection or certain other infectious diseases may also be causes of Asherman’s syndrome. [rarediseases.org]
For example, chronic inflammation in the pelvic cavity may influence a woman’s risk of ovarian cancer. [endometriosis.org]
When blood touches these other organs, especially inside the abdomen, it can cause inflammation and irritation, creating pain. Sometimes, scar tissue can also develop from the endometriosis which can also contribute to the pain. [uclahealth.org]
This research discusses evidence of a higher expression of the genes related to proliferation, inflammation and immune response — including the genes TGFB2 and ligand 18 — during the early endometrial proliferative phase. [volusonclub.net]
- Surgical Procedure
However, because laparoscopy is a surgical procedure, requiring an incision and anesthesia, it is not suitable for some patients. [britannica.com]
This is a same-day surgical procedure and in some gynecologic practices, it is also performed in the office instead of the operating room. [verywellhealth.com]
procedure) may be called upon to confirm a diagnosis of endometriosis Endometriosis cannot be cured, but both medical and surgical options can offer relief from its symptoms. [leading-medicine-guide.com]
A nationwide centralization of complex surgical procedures induces a high flow of patients and gives the optimal conditions for improving surgical expertise in complex surgical procedures for the treatment of cancer. [ncbi.nlm.nih.gov]
- Pathologist
The pathologist is faced with making a decision on whether the biopsy specimen is adequate. [ncbi.nlm.nih.gov]
Endometrial hyperplasia can only be diagnosed after your endometrium has been sampled and evaluated under the microscope by a pathologist. [verywellhealth.com]
Several histopathology subtypes of endometrial hyperplasia are recognisable to the pathologist, with different therapeutic and prognostic implications.[3] The most commonly used classification system for endometrial hyperplasia is the World Health Organization [en.wikipedia.org]
सबसे pathologists का मानना है कि एक Leiomyosarcoma एक डे नोवो बीमारी [प्रशस्ति पत्र की जरूरत है]. [helpebookhindi.wikifoundry.com]
The endometrial gland cells display the same array of endocrine receptors as are expressed in animal species, and pathologists have long recognised the hypersecretory phenotype that the glands adopt in early pregnancy, the so-called Arias-Stella reaction [isshp.org]
Respiratoric
- Aspiration
Likely your doctor will then place a grasper to hold your cervix in place while the small aspirator device is inserted. You will likely experience some discomfort. You won’t feel anything sharp but you will have some cramping. [verywellhealth.com]
Gastrointestinal
- Abdominal Pain
Symptoms of Endometriosis Endometriosis Symptoms Pain, including pelvic or lower abdominal pain and pain with menses, is the most common symptom of endometriosis. Women may also have pain with intercourse. [uclahealth.org]
One example is endometriosis, which is characterised by growth of endometrial-like tissue outside the uterine cavity, resulting in chronic abdominal pain and painful sexual intercourse. Up to half of the patients are sub-fertile or infertile. [ecancer.org]
One example is endometriosis, which is characterised by growth of endometrial-like tissue outside the uterine cavity, resulting in chronic abdominal pain and painful sexual intercourse. Up to half of the patients are subfertile or infertile. [sciencedaily.com]
Common signs and symptoms of endometriosis include: Painful periods or dysmenorrhea. Cramping and pelvic pain may begin before and it may extend several days into a menstrual period. You may also have abdominal pain and lower back pain. [sciencetimes.com]
- Diarrhea
It may be mistaken for IBS or irritable bowel syndrome, a condition that causes constipation, diarrhea, and abdominal cramping. IBS can accompany endometriosis, and this can complicate the diagnosis. [sciencetimes.com]
It may be confused with irritable bowel syndrome (IBS), a condition that causes bouts of diarrhea, constipation and abdominal cramping. IBS can accompany endometriosis, which can complicate the diagnosis. [mayoclinic.org]
[…] include: Severe menstrual cramps, unrelieved with NSAIDS Long-term lower-back and pelvic pain Periods lasting longer than 7 days Heavy menstrual bleeding where the pad or tampon needs changing every 1 to 2 hours Bowel and urinary problems including pain, diarrhea [medicalnewstoday.com]
These include diarrhea, constipation, bloating, or nausea, especially during menstrual periods. Why does endometriosis cause pain and health problems? Endometriosis growths are benign (not cancerous). But they can still cause problems. [womenshealth.gov]
If you have severe menstrual pain, you might also find you have some diarrhea or an occasional feeling of faintness where you suddenly become pale and sweaty. [healthywomen.org]
Cardiovascular
- Heart Disease
heart disease, breast cancer, and uterine cancer. da Cuba – Kommissionens delegation en This must be investigated by your doctor. [da.glosbe.com]
Women with PCOS are at increased risk of developing diabetes and heart disease. Symptoms may include Infertility. Pelvic pain. Excess hair growth on the face, chest, stomach, thumbs, or toes. Baldness or thinning hair. Acne, oily skin, or dandruff. [cdc.gov]
Endometriosis and Risk of Coronary Heart Disease. Circulation: Cardiovascular Quality and Outcomes 2016. Hornstein MD, et al. Association between endometriosis, dysplastic naevi and history of melanoma in women of reproductive age. [endometriosis.org]
- Chest Pain
Rare symptoms of endometriosis include chest pain or coughing blood due to endometriosis in the lungs and headache and/or seizures due to endometriosis in the brain. [medicinenet.com]
Musculoskeletal
- Osteoporosis
[…] only true of access to sexual and reproductive healthcare; there is also discrimination when it comes to diagnosis and treatment as a whole, particularly as regards what are deemed women’s diseases, such as fibromyalgia, breast and uterine cancer and osteoporosis [da.glosbe.com]
Estrogen treatment can help reduce hot flashes, improve vaginal dryness, and help prevent the weakening of the bones (osteoporosis) that can occur with menopause. [cancer.org]
However, their hypoestrogenic adverse effects (eg, osteoporosis) limit their use to 6 mo; they are often used concurrently with low-dose hormone therapy. Ergot derivatives are not recommended for treatment of AUB-O because they are rarely effective. [msdmanuals.com]
The side effects are a result of the lack of estrogen, and include: hot flashes, vaginal dryness, irregular vaginal bleeding, mood alterations, fatigue, and loss of bone density (osteoporosis). [medicinenet.com]
- Back Pain
Common signs and symptoms of endometriosis include: Painful periods or dysmenorrhea. Cramping and pelvic pain may begin before and it may extend several days into a menstrual period. You may also have abdominal pain and lower back pain. [sciencetimes.com]
However, there may be other symptoms too, such as: acutely painful menstrual cramps lower back pain just before beginning a menstrual period experiencing pain during sexual intercourse vaginal bleeding after sexual intercourse abdominal swelling fever [leading-medicine-guide.com]
This “misplaced” tissue can cause pain, infertility, and very heavy periods. The pain is usually in the abdomen, lower back, or pelvic areas. [cdc.gov]
decreased bladder sensitivity, macroscopic hematuria, lower back pain…) imply an infiltration of the hypogastric plexus by endometriosis lesions, in combination with inflammatory phenomena. [frontiersin.org]
Other symptoms that can be related to endometriosis include lower abdominal pain, diarrhea and/or constipation, low back pain, chronic fatigue irregular or heavy menstruation, painful urination, or bloody urine (particularly during menstruation). [medicinenet.com]
Skin
- Hirsutism
Hirsutism It is the growth of terminal hairs on the face or body in a male pattern. It is the most important feature of PCOS, affecting 65-75 percent of women and varies with ethnicity. [doctorflame.com]
Transvaginal ultrasonography is done if women have any of the following: Risk factors for endometrial cancer (eg, obesity, diabetes, hypertension, polycystic ovary syndrome, chronic eugonadal anovulation, hirsutism, other conditions associated with prolonged [msdmanuals.com]
Evaluate for Body mass index (obesity) Pallor, vital signs (anemia) Visual field defects (pituitary lesion) Hirsutism or acne (hyperandrogenism) Goiter (thyroid dysfunction) Galactorrhea (hyperprolactinemia) Purpura, ecchymosis (bleeding disorders) Pelvic [unboundmedicine.com]
These include: Weight gain Edema (swelling) Breast shrinkage Acne Oily skin Male pattern hair growth (Hirsutism) Deepening of the voice Headache Hot flashes Changes in libido Mood alterations Except for the voice changes, all of these side effects are [medicinenet.com]
An examination may include: A general physical assessment including weight, blood pressure and pulse rate Assessment for signs suggestive of an underlying condition, for example:4 Thyroid nodule or goitre - thyroid disease Acne, hirsutism, androgenic [bpac.org.nz]
Urogenital
- Pelvic Pain
Endometriosis is usually mistaken for other conditions that can cause pelvic pain like PID or pelvic inflammatory disease or ovarian cysts. [sciencetimes.com]
Pain Foundation Australia to deliver endometriosis, period, and pelvic pain education in secondary schools $123,586 to RANZCOG to develop online learning resources for medical practitioners $39,360 to the Australian College of Nursing to develop an online [health.gov.au]
Among the different types of degeneration, the haemorrhagic one is most likely to cause acute pelvic pain. [insightsimaging.springeropen.com]
Symptoms of adenomyosis include abnormal uterine bleeding and pelvic pain. Approximately 60 percent of women with adenomyosis experience abnormal uterine bleeding, and 25 percent experience dysmenorrhea (pelvic pain during menstruation). [brighamandwomens.org]
- Vaginal Bleeding
When to Call a Doctor Call a doctor if you develop heavy vaginal bleeding or if you experience vaginal bleeding between periods or after menopause. [healthcommunities.com]
Vaginal bleeding after menopause is one of the most common signs of endometrial cancer. If you have vaginal bleeding after menopause you should immediately consult your physician. [columbiadoctors.org]
Irregularities in the pattern and amount of vaginal bleeding of uterine origin are often signs of pathology or an aberration in the function of the hypothalamic, pituitary, and ovarian system. [books.google.com]
The first sign is most often vaginal bleeding not associated with a menstrual period.bOther symptoms include pain with urination, pain during sexual intercourse, or pelvic pain. [play.google.com]
[…] uterine sarcoma, unusual vaginal bleeding or spotting is the most common symptom. [cancercenter.com]
- Dysmenorrhea
It may or may not be accompanied by dysmenorrhea. [amboss.com]
Contraceptive options include A levonorgestrel -releasing intrauterine device (IUD): It is effective in up to 97% by 6 mo, provides contraception, and relieves dysmenorrhea. [msdmanuals.com]
Approximately 60 percent of women with adenomyosis experience abnormal uterine bleeding, and 25 percent experience dysmenorrhea (pelvic pain during menstruation). [brighamandwomens.org]
Symptoms associated with this disease include (1) progressive, severe pain associated with menstruation or occurring just before it (dysmenorrhea), (2) dyspareunia (painful intercourse), (3) painful defecation, (4) slight bleeding before menstruation [britannica.com]
Common signs and symptoms of endometriosis include: Painful periods or dysmenorrhea. Cramping and pelvic pain may begin before and it may extend several days into a menstrual period. You may also have abdominal pain and lower back pain. [sciencetimes.com]
- Amenorrhea
Physiological amenorrhea occurs before menarche, after menopause, during pregnancy, and during lactation. [amboss.com]
Called amenorrhea, or the absence of menstruation, this condition is normal before puberty, after menopause and during pregnancy. There are two kinds of amenorrhea: primary and secondary. [healthywomen.org]
Anovulatory AUB can result from any disorder or condition that causes anovulation (see Table: Some Causes of Anovulatory Amenorrhea ). [msdmanuals.com]
Patients experience reduced menstrual flow, increased cramping and abdominal pain, eventual cessation of menstrual cycles (amenorrhea), and, in many instances, infertility. [rarediseases.org]
GnRH (gonadotropin releasing hormone) agonists have been used in a few cases, resulting in a temporary decrease in uterine size, in amenorrhea (cessation of menstrual cycling), and even in the ability to conceive. [brighamandwomens.org]
- Cesarean Section
For example, a woman with endometriosis that undergoes a cesarean section could inadvertently have some endometriosis cells attach to the abdominal incision so that she has endometriosis in the scar from the surgery. [uclahealth.org]
It can be caused by repeated dilatation and curettages (D&Cs), pelvic infection, Cesarean section, and other uterine surgery. Sometimes, its cause is unknown. Asherman’s syndrome can cause trouble with conception and repeated miscarriage. [verywellfamily.com]
Cesarean section and disease associated with immune function. J Allergy Clin Immunol 2016;137:587-590. 19. De Filippo C, Cavalieri D, Di Paola M, Ramazzotti M, Poullet JB, Massart S, Collini S, Pieraccini G, Lionetti P. [bestprac.fi]
It is also likely the direct transfer of endometrial tissues at the time of surgery may be responsible for the endometriosis implants occasionally found in surgical scars (for example, episiotomy or Cesarean section scars). [medicinenet.com]
This means that pregnancy is still possible, although a Cesarean section may be necessary. Recovery time after a myomectomy is about 3 to 4 weeks. [archive.ahrq.gov]
Workup
A workup for endometrial disease may be prompted by abnormal uterine bleeding, or the presence of atypical glandular cells on a pap smear.[6] Treatment[edit] Treatment of endometrial hyperplasia is individualized, and may include hormonal therapy, such [en.wikipedia.org]
Precautions Failed medical treatment requires further workup. Consider DVT prophylaxis when treating with high-dose estrogens (2)[C]. [unboundmedicine.com]
An accurate preoperative workup (anamnesis, clinical examination, and imaging information; cystoscopy) is essential for planning a correct laparoscopic approach. [frontiersin.org]
Microbiology
- Chlamydia
There are a range of causes, including: STIs, e.g. chlamydia or gonorrhoea infection Cervical ectropion or polyps Atrophic vaginitis Cervical cancer Vaginal cancer Trauma Laboratory and imaging tests that may be indicated when investigating post-coital [bpac.org.nz]
[…] is suspected Follicle-stimulating hormone (FSH) and estradiol levels if primary ovarian insufficiency is possible A cervical cancer screening test (eg, Papanicolaou [Pap] test, HPV test) if results are out-of-date Testing for Neisseria gonorrhea and Chlamydia [msdmanuals.com]
PID results from untreated ascending microbial infection from the vagina by sexually transmitted microorganisms such as Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and gram-negative bacteria; mixed aerobic and anaerobic infections [insightsimaging.springeropen.com]
Stern RA, Svoboda-Newman SM, Frank TS (1996) Analysis of chronic endometritis for Chlamydia trachomatis by polymerase chain reaction. Hum Pathol 27:1085–1088 PubMed CrossRef Google Scholar [249.] [link.springer.com]
Treatment
The SIGEED addresses all aspects of these disorders: pathogenesis (endometrial biology), epidemiology, diagnosis, medical and surgical* treatment, quality of life and social consequences of the disease, and complementary approaches to treatment. (*)endometriosis [eshre.eu]
Remember, all treatments—including medicine, surgery, other types of treatments, and even a decision to wait or not be treated—have risks and benefits. Be sure to ask your doctor about the risks and benefits of each treatment option you are offered. [archive.ahrq.gov]
For example, hormonal treatment (instead of surgical treatment) of endometrial cancer may better preserve fertility. With conservative surgical treatment, women post-endometrial cancer treatment can have problems with a thin endometrium. [verywellfamily.com]
If your BMI is over 35, it is more likely that progesterone treatment will not work well unless you also lose weight. You should discuss with your doctor which type of progesterone treatment is best for you. [verywellhealth.com]
Prognosis
Young women with endometrial carcinoma are considered to have a favorable prognosis with early stage, well differentiated lesions. In this report we present young patient with advanced stage endometrial adenocarcinoma who had poor prognosis. [atif.sobiad.com]
These are associated with either endogenous or exogenous unopposed estrogen exposure and usually consist of a low-grade or well-differentiated tumor with a favorable prognosis. [accessmedicine.mhmedical.com]
Management and prognosis of endometrioid borderline tumors of the ovary. Surg Oncol. 2012;21:178–84. 7. Bell KA, Kurman RJ. [ovarianresearch.biomedcentral.com]
Bergman L, Beelen ML, Gallee MP, Hollema H, Benraadt J, van Leeuwen FE (2000) Risk and prognosis of endometrial cancer after tamoxifen for breast cancer. Comprehensive Cancer Centres' ALERT Group. [link.springer.com]
Answer all questions, especially those related to cancer and fertility. https://www.acog.org/Patients https://www.uptodate.com (patient education) Prognosis Varies with pathophysiologic process Most anovulatory cycles can be treated with medical therapy [unboundmedicine.com]
Etiology
Differential Diagnosis See “Etiology and Pathophysiology.” [unboundmedicine.com]
Secondary amenorrhea Definition: absence of menses for more than 3 months (in women with previously regular cycles) or 6 months (in women with previously irregular cycles) Etiology Pregnancy → most common cause of secondary amenorrhea Ovarian disorders [amboss.com]
Multifactorial etiology of recurrent miscarriage and its scientific and clinical implications. Gynecol Obstet Invest. 2008; 66: 257–267. 26. Miravet- Valenciano JA, Rincon- Bertolin A, Vilella F, Simon C. [monz.pl]
The etiology of adenomyosis is currently unknown. [nature.com]
Its etiology and pathogenesis are controversial but it is believed to involve multiple, genetic, environmental, immunological, angiogenic, endocrine, and even embryonic processes (1, 2). [frontiersin.org]
Epidemiology
The SIGEED addresses all aspects of these disorders: pathogenesis (endometrial biology), epidemiology, diagnosis, medical and surgical* treatment, quality of life and social consequences of the disease, and complementary approaches to treatment. (*)endometriosis [eshre.eu]
Uniform histopathologic and imaging criteria are needed in order to standardize the diagnosis and to have reliable epidemiological figures. Lay Summary Scientists, Drs. [endonews.com]
Epidemiology 2005;16(4):500-7. Buis CC, et al. Increased risk for ovarian cancer and borderline ovarian tumours in subfertile women with endometriosis. Hum Reprod 2013;28(12):3358-69 Cottreau CM, et al. [endometriosis.org]
The association between endometriosis and gynecological cancers and breast cancer: A review of epidemiological data. Gynecologic Oncology, 123, 157-163. This content is provided by the Office on Women's Health. [womenshealth.gov]
Commonly associated with anovulation Epidemiology Adolescent and perimenopausal women are affected most often. Incidence 5% of reproductive-aged women will see a doctor in any given year for AUB. [unboundmedicine.com]
Pathophysiology
[…] maximise public and European government awareness of endometriosis and endometrial disorders Mission statement The SIGEED combines a basic and a clinical focus on research and training related to endometriosis and endometrial disorders (e.g. endometrial pathophysiology [eshre.eu]
Differential Diagnosis See “Etiology and Pathophysiology.” [unboundmedicine.com]
Burton, FMedSci Director of Centre for Trophoblast Research University of Cambridge Pre-eclampsia is a syndrome defined by unique diagnostic criteria laid down by the ISSHP, but is just one of a number of complications of pregnancy that share a common pathophysiology [isshp.org]
Role of nuclear progesterone receptor isoforms in uterine pathophysiology. Hum. Reprod. Update 21, 155–173 (2015). 29. Wu, Y., Strawn, E., Basir, Z., Halverson, G. & Guo, S.-W. [nature.com]
Prevention
Endometriosis cannot be prevented. The fact that this disorder is poorly understood is a contributing factor, though long-term treatment with birth-control hormones has often been shown to help prevent the condition from getting worse. [leading-medicine-guide.com]
(Treatment is discussed in Can endometrial cancer be prevented?) [cancer.org]
Can endometrial hyperplasia be prevented or avoided? You are more likely to have endometrial hyperplasia if you have gone through menopause. This is because your body’s hormones and menstrual cycles change. [familydoctor.org]
[…] of Endometrial Hyperplasia Although endometrial hyperplasia cannot be prevented, women should have regular pelvic examinations once they reach age 18 or become sexually active, to aid in early detection and treatment of any abnormalities. [healthcommunities.com]
Learn more from CDC’s Act Against AIDS campaign including how HIV is spread, and how to prevent HIV. [cdc.gov]